Statins: How They Work, Side Effects, and Interactions

Cholesterol is a type of lipid that is critical for the survival of the human body, even though often associated with negative implications1.

Two different types of cholesterol can reside in the body – and this is where the confusion often comes into play

LDL cholesterol is considered a “bad” type of lipid, causing a collection of fatty content in the arteries. This can contribute to heart disease, as well as a higher risk of heart attacks and strokes.

The other type of lipid is called HDL cholesterol, which is the “good” kind of cholesterol in the body. HDL cholesterol helps to clear the blood circulatory system of the fatty content that builds up with high levels of LDL cholesterol.

When total cholesterol and LDL cholesterol levels increase too much, it can cause several adverse effects.

Various drugs have been developed to assist in reducing cholesterol.

Statins are one of the most commonly prescribed in the USA, with more than 35 million people taking them.

We consider the use of statins in this post, along with both the positive effects and adverse events that these drugs may impose. Both are essential factors patients do need to realize before using the medicine.

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What Are Statins?

Statin is a term used to refer to a wide variety of drugs used to treat an elevated level of cholesterol. This is a pharmaceutical drug that is most often provided to patients with high levels of LDL cholesterol or low-density lipoprotein.

Total cholesterol is also taken into account when a physician is considering a prescription of statins.

These drugs have become the standard treatment option for patients with high cholesterol levels.

Many studies have shown that statins can provide a safe way of reducing cholesterol levels. They have also been shown to lower the risk of heart disease, as well as other potential problems that can occur with this condition.

The most common type of statin that is prescribed to patients with high cholesterol is usually atorvastatin. However, there are other options available, including pitavastatin, rosuvastatin, simvastatin, and lovastatin.

In Which Situations Are Statins The Best Choice?

Not every patient with an elevation in cholesterol levels makes a good candidate for the use of statins.

A physician will usually assess the situation carefully before prescribing statins.

Patients who are at risk of cardiovascular disease caused by the increase in cholesterol levels might want to consider the use of these drugs.

These pills are often also prescribed to patients who experienced a heart attack in the past. This puts the person at specific risks, and the use of a statin drug may be helpful.

Those with total cholesterol that is higher than 200 milligrams per decilitre, as well as those with a level of LDL cholesterol that is higher than 130 mg/dL, might benefit from taking a statin drug.

What Are The Pros And Cons Of Statins?

There are both pros and cons associated with statins. These should be considered and weighed by any person who may be advised of the use of statins.

The significant pros linked to the use of these drugs would be an effective reduction in blood cholesterol levels, which is undoubtedly a critical part of reducing the risk of cardiovascular and blood vessel complications.

There are, however, some potential risks that come with the use of a statin drug. Patients need to take note that several possible side-effects may be experienced.

Those with existing liver problems also need to speak to their doctor about the possibility of suffering further liver damage3.

Conditions Treated By Statins

Statins are primarily used to assist in the treatment of high cholesterol. These drugs have been shown to provide an effective way of reducing levels of cholesterol.

In turn, this may assist in providing an improvement in certain symptoms caused by an elevated blood cholesterol level.

Doctors may sometimes prescribe the medication to patients suffering from conditions that may increase their risk of elevated cholesterol.

This might assist in providing a reduction in the risk factors that play a role in the development of several conditions – and could even improve the outcome of certain diseases.

The use of statins has been found to reduce the amount of cholesterol present in the blood circulatory system of the patient.

Also, it has also been found that these drugs may provide an anti-inflammatory effect.

One study4 showed that individuals with atherogenesis might benefit from the use of statins, mainly because the drug can yield an anti-inflammatory effect.

Therefore, patients diagnosed with atherosclerotic cardiovascular disease may benefit from a treatment plan that includes statins.

The anti-inflammatory effects statins seem to yield would also possibly be helpful for a person who is suffering or at high risk of cardiovascular disease. Such risk factors would include inflammation of the blood vessels, of course, as well as hypertension.

There is some research being conducted on how the use of statins may further benefit the patient.

At the moment, there seems to be a focus on determining whether or not the use of statins would be beneficial for patients who are at risk of pulmonary embolism. This is a condition where blood clots develop in their lungs.

Additionally, the drug is also being assessed for its usefulness in the prevention of deep vein thrombosis.

How Do Statins Work?

To understand how statins work, it is important to take note that cholesterol collects in the body through two different mechanisms. The first is a natural mechanism in the body that produces cholesterol.

The second would be from the foods that we eat. When food is high in saturated fats, and it contributes to an increased level of cholesterol too.

There is a very specific enzyme that helps the liver produce cholesterol. The enzyme is known as HMG CoA Reductase. There are some cases where the enzyme may cause too many cholesterol compounds to be produced in the body. This can lead to a higher risk of cardiovascular disease, stroke, and heart attacks.

When a patient has prescribed a dose of statins daily, then the activity of the HMG CoA Reductase enzyme is reduced.

The reduced activity of the enzyme will help to reduce the production of cholesterol in the liver of the patient.

When this enzyme’s activity is inhibited, the patient should take note that this does not mean they will not experience an elevated level of cholesterol again.

Side Effects Of Statins

While statins are generally well-tolerated in both men and women, it is critical to be aware of the potential side-effects.

Additionally, some people may not be good candidates for the use of statins, as there are some diseases and conditions that may interfere with a statin drug’s ability to work effectively.

In some cases, when using statins with existing disease, there may be further complications.

Some of the risks and adverse effects that have been associated with statins are more serious than others.
Some of the most important side-effects that occur include:

  • Liver damage: A critical factor that needs to be taken into account is that some people may be at risk of liver damage when they take statins. This is a more severe concern among individuals who have existing damage to their liver.

    At the same time, it is important to note that there have been cases where a patient suffers liver damage even if they do not have an existing condition that affects this particular organ. The damage is caused by an elevation of a specific enzyme that has been associated with an inflammatory reaction in the human body.

  • Myopathies: Some patients who take statins have reported the development of myopathies. This is a medical term that refers to muscle pain. The patient may experience accompanying symptoms. In addition to muscles becoming painful, there may be discomfort, especially when the patient moves.

  • Blood Sugar Spikes: Patients who have metabolic syndrome need to be extra careful when they consider using statins. This is because the drug may cause blood sugar levels to increase. When the patient fails to take note of this side-effect, it may cause an increase in the individual’s risk of developing type 2 diabetes. This is a serious side-effect associated with the use of statins. In fact, the FDA requires companies to add a warning label that tells the patient they might be at an elevated risk for type 2 diabetes if they use the drug.

  • Cognitive dysfunction: Some people tend to experience impairment in their cognitive function. There may be problems with memory function. Some people also find that the drug causes them to experience issues with their ability to concentrate properly.

How Serious Are The Side Effects Of Statins?

While some side-effects associated with statins will only be mild, more serious adverse events may occur. This occurs in patients who experience a rise in blood sugar levels significant enough to put them at risk of type 2 diabetes.

Severe effects can also occur in those who suffer an inflammatory trigger in the liver.

Additionally, another serious side-effect of statins that should be noted is myositis. This is a worse type of myopathies, where muscles become severely inflamed.

While only a minimal number of patients who take statins are affected by this particular side-effect, it is still an important note to take for anyone who might consider using these drugs. When myositis is experienced as a side-effect, it can cause permanent damage to muscle tissue.

Natural Alternatives To Statins

Due to the number of potential side-effects that have been associated with statin medications, some people may want to consider natural alternatives.

Many alternative options have been suggested to statins – mainly to assist in reducing high cholesterol levels and reduce the risk of cardiovascular disease.

It is important to note that not all of these natural alternatives have been scientifically proven to yield effective results.

It is always important to do research and find natural options that have been proven to work.

  • Red yeast rice: A fermented type of rice product that may help to reduce both triglyceride levels, as well as total cholesterol levels, in the human body. Monacolin K is the main enzyme to be taken note of here, which produces the cholesterol-lowering effect5.

  • Plant sterols: A collective term for certain chemicals found in plants, which are sometimes added to supplements. These chemicals may have the ability to reduce LDL cholesterol levels.

  • Fibrates: Another natural substance that may aid in reducing levels of triglycerides in the body, particularly in those individuals who are at risk of pancreatitis.

Other options include the use of Niacin supplements, as well as Cholestyramine, which is considered a bile acid-binding resin.

These natural supplements are generally available at both online and physical stores that specialize in the production and sale of herbal remedies and dietary pills.

Sources

  1. StatPearls [Internet]. 2019. Physiology, Cholesterol. [online] Available at: https://www.ncbi.nlm.nih.gov/books/NBK470561/
  2.  The Journal of Clinical Investigation. 2002. Cholesterol in health and disease. [online] Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC151113/
  3. Gastroenterology & Hepatology Journal. 2013. Statins and Liver Injury. [online] Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3983981/
  4. Current Pharmaceutical Design Journal. 2012. Statins as Anti-Inflammatory Agents in Atherogenesis: Molecular Mechanisms and Lessons from the Recent Clinical Trials. [online] Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3394171/
  5.  Journal of Pharmacy and Therapeutics. 2009. Safety and Efficacy of Red Yeast Rice (Monascus purpureus) as an Alternative Therapy for Hyperlipidemia. [online] Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2697909/

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